Clinical Review

Science, medicine, and the future

Omega 3 fatty acids and cardiovascular disease—fishing for a natural treatment

BMJ 2004; 328 doi: 10.1136/bmj.328.7430.30 (Published 1 January 2004)
Cite this as: BMJ 2004;328:30

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  1. Jehangir N Din (jehangirdin@hotmail.com), research fellow1,
  2. David E Newby, reader1,
  3. Andrew D Flapan, consultant cardiologist2
  1. 1Cardiovascular Research, University of Edinburgh, Edinburgh EH16 4SB
  2. 2Royal Infirmary of Edinburgh, Edinburgh EH16 4SA
  1. Correspondence to: J N Din
  • Accepted 6 November 2003

Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease. This article reviews the evidence regarding fish oils and coronary disease and outlines the mechanisms through which fish oils might confer cardiac benefits

Introduction

Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease. Both health professionals and the public are increasingly interested in their role in the prevention and management of coronary heart disease. In this era of multiple pharmacological treatments for cardiovascular disease many believe that simple dietary interventions or nutritional supplements may be a more natural and acceptable method of providing benefits.

Several areas of uncertainty remain. The optimal intake of omega 3 fatty acids is not firmly established, nor is their mechanism of action fully understood. Some studies have produced conflicting results, and concerns have been increasing about environmental contamination of certain fish. This article reviews the current evidence regarding fish oils and cardiovascular disease, their possible mechanism of action, and potential future developments and research strategies.

Sources and selection criteria

We searched PubMed for relevant articles by using the key words “fish,” “fish oils,” “omega 3 fatty acids,” and “cardiovascular disease.” References identified in the search are on bmj.com

Summary points

Coronary heart disease is still the most common cause of death in the United Kingdom

Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease

There is evidence to support the use of fish or fish oil supplements after myocardial infarction

The mechanisms by which fish oils confer their benefits are not fully understood

Unravelling these mechanisms may identify novel therapeutic targets and could help guide the development of future treatments for coronary heart disease

Future trials may identify other patients who could benefit, such as those with stable angina, risk factors for coronary heart disease, …

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